New Institute Aims to Get the Medications Right

Drug Topics JournalDrug Topics July 2019
Volume 163
Issue 7

Comprehensive medication management may lower costs and improve lives. 

Terry McInnis, MD, MPH

Terry McInnis, MD, MPH

We spent roughly $480 billion for prescription drugs in 2016. We wasted $528 billion on nonoptimized medication use.  

Why? The reasons are complex. 

First, we lack a systematic coordinated approach to medication management that can ensure medications are appropriately and effectively used. 

Second, we are in the midst of the greatest evolution in healthcare, a transition from population health-based clinical guidelines to personalized precision medicine. Whole genome sequencing reveals new mutations and is allowing ever greater precision. Advances in pharmacogenomics, diagnostics, targeted therapies, and even microbiome influences are progressively narrowing our understanding of drug and genetic therapy from a shot gun approach to laser certainty. 

Third, policy and payments must align with these scientific and delivery system realities if we are to close the gap between scientific discovery and direct patient care.

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This is why we launched the Get the Medications Right (GTMRx) Institute with a specific crosscutting-and, I believe, unique-focus: Bring critical stakeholders together, bound by the need to optimize outcomes and reduce costs by getting the medications right. 

More than 200 members come from both the practice delivery side-including the underused services of clinical pharmacists and genetic counselors-as well as the IT and analytics/artificial intelligence, advanced diagnostics, and policy and payment spheres, all working with patients to transform care. 

Our goal is to attack the issue of nonoptimized medication use. We’re engaging physicians, clinical pharmacists and other providers to transform practice and integrate comprehensive medication management (CMM) as the means by which to focus on this personalized precision approach to medication management. We’re boosting evidence while informing payers and policymakers about CMM’s promise to lower costs and improve lives.  

Understanding CMM

What is CMM, and why do we believe it will optimize clinical outcomes? It’s a systematic approach to medications where physicians and pharmacists ensure that medications-prescription, nonprescription, alternative, traditional, vitamins, or nutritional supplements-are assessed to determine that each is appropriate for the patient, effective, safe, and able to be taken by the patient as intended. 

CMM optimizes medical outcomes by ensuring medications are appropriately and effectively used. This not only boosts cost-effectiveness; it assures that all conditions are effectively managed, building the bridge from trial-and-error population-based medication use to personalized science-and-data-driven medication therapy.

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It’s important to distinguish between CMM and other forms of medication therapy management (MTM). CMM is patient-centric, based on optimizing the clinical goals of therapy, and was defined by the Patient-Centered Primary Care Collaborative. 

Many organizations have taken to calling what they do “comprehensive medication management.” They may do two or three components, but no more. CMM includes 10 specific elements. An organization must do all 10; otherwise, it isn’t providing comprehensive medication management. 

Medical knowledge is said to be doubling every 73 days. With medications representing 80% to 85% of how we prevent and treat disease, we must focus on optimizing medications. 

It’s time to get the medications right.

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